Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis
Adam EK · Quinn ME · Tavernier R · McQuillan MT · Dahlke KA · Gilbert KE
Psychoneuroendocrinology · 2017
What the research tells us
Flatter diurnal cortisol slopes were modestly associated with poorer health: pooled r=.147 (95% CI .112–.183), and r=.138 (.005–.267) in prospective studies. These results support research on diurnal rhythms and health, not diagnosis of an individual's stress from a single measurement.
Scope & interpretation
Heterogeneity was high (I²=83.23%); effect conversion, adjustment and publication-bias handling varied. The bias-adjusted mortality HR was 1.69 (.55–5.2), crossing 1 although the text calls it significant. This unresolved inconsistency prevents a claim of a robust significant mortality association.
Study at a glance
- POPULATION & SAMPLE
- 80 studies with 179 associations spanning mental and physical health outcomes.
- EXPOSURE / INTERVENTION / SUBJECT
- Flatter versus steeper diurnal slopes; multiple outcomes within studies were averaged before synthesis.
- OUTCOMES
- Mental and physical health, prospective health outcomes and mortality, kept distinct from individual risk scoring.
- TIME FRAME
- Search through 31 January 2015; cross-sectional and prospective studies with varying follow-up.
Editorial & review record
Record for v1.0 · Updated
Editorial responsibility: TAP Editorial Team
Scientific review
Not yet scientifically reviewed
Editorial note
Under the editorial responsibility of the TAP Editorial Team, this publication used AI assistance for content organization and editing. Scientific review is recorded separately on this page.
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How responsibilities and review are recorded ↗Scope of this reading note
Full-text selection/synthesis methods, overall, prospective and mortality results, and limitations. Original mortality estimates and synthesis code remain to be checked.
- Study funding
- Support included Northwestern Institute for Policy Research faculty and graduate funding; see the acknowledgements.
- Competing interests
- The authors declare no conflicts and report that funders were not involved in analysis or interpretation.
Project support
Founded and supported by Resilio.
Revision history
- · v1.0
Added the cortisol-slope synthesis, high heterogeneity and the unresolved mortality text–interval discrepancy.